Provider Demographics
NPI:1811380744
Name:KEEP IN ACTION PHYSICAL THERAPY
Entity Type:Organization
Organization Name:KEEP IN ACTION PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-413-6685
Mailing Address - Street 1:12 APPLETREE LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1926
Mailing Address - Country:US
Mailing Address - Phone:718-413-6685
Mailing Address - Fax:212-889-9655
Practice Address - Street 1:12 APPLETREE LN
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-1926
Practice Address - Country:US
Practice Address - Phone:718-413-6685
Practice Address - Fax:212-889-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026613251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health